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Washington rates for HCPCS J1455

Injection, foscarnet sodium, per 1,000 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $13.49 / $23.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $6.03 / $8.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $6.31 / $43.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $8.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $19.95 / $30.20
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $64.57 / $165.96
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.14 / $23.44 / $23.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $61.66 / $141.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.76 / $8.71